Purpose:
This study aimed to assess the yearly frequency of ranibizumab injections for the treatment of wet Age-Related Macular Degeneration (wAMD) in two large Canadian public drug plans: Ontario Drug Benefit (ODB) program and Régie de l’assurance-maladie du Québec (RAMQ).

Methods:
Patient longitudinal drug utilization database RxDynamics® (IMS Health Canada Inc.) was used to assess the mean annual number of ranibizumab injections for wAMD patients covered by ODB or RAMQ drug plans (1 injection was defined as 1 claim). Only wAMD treatment-naïve patients were included and the index date was defined as the date of the first ranibizumab claim. The analysis looked at monthly data from March 2008 to November 2012 for ODB patients and from January 2008 to May 2012 for RAMQ patients and tracked the mean number of claims during the patient's first, second, third and fourth year of ranibizumab therapy.

Results:
For the ODB, the mean number of ranibizumab injections was 6.0, 5.4, 5.5 and 5.6 for year 1 (N=26,606), year 2 (N=19,466), year 3 (N=12,708), and year 4 (N=6,681), respectively. For the RAMQ, the mean number of injections was 5.4, 4.7, 5.2 and 5.7 for year 1 (N=3,457), year 2 (N=2,185), year 3 (N=1,178), and year 4 (N=349), respectively.

Conclusions:
These results suggest that many Ontario and Quebec retina specialists and ophthalmologists adopt an individualized ranibizumab treatment regimen to manage their patients’ wAMD. In addition, these results provide information on the real-world utilization of ranibizumab in wAMD for up to four years of treatment.